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Hereditary hemorrhagic telangiectasia (HHT) is characterized by repeated episodes of epistaxis; iron-deficiency anemia; telangiectasias; and arteriovenous malformations (AVMs) in the lungs, liver, gastrointestinal tract, and brain. Occasionally, multiple AVMs are located in the liver, resulting in extensive hepatic shunting and high-output cardiac failure. Aside from liver transplantation, few other options are available for patients with this complication. However, there might be a role for agents that target vasculogenesis, such as inhibitors of vascular endothelial growth factor (VEGF).
To assess whether the VEGF inhibitor bevacizumab reduces cardiac output and improves epistaxis duration in this setting, French investigators conducted an…